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实验性高血压中血管收缩系统与血管舒张系统之间的平衡改变

Altered Balance between Vasoconstrictor and Vasodilator Systems in Experimental Hypertension.

作者信息

Zicha J, Vaněčková I

机构信息

Laboratory of Experimental Hypertension, Institute of Physiology, Czech Academy of Sciences, Prague, Czech Republic.

出版信息

Physiol Res. 2024 Dec 31;73(6):901-928. doi: 10.33549/physiolres.935523.

Abstract

Sympathetic hyperactivity and relative NO deficiency are characteristic alterations in both genetic and salt hypertension. The contribution of these abnormalities to blood pressure (BP) maintenance can be determined in conscious rats using a consecutive blockade of particular vasoactive systems. Thus, the contribution of pressor effects of angiotensin II to the maintenance of high BP is usually small, but the role of renin-angiotensin system in the development of hypertension mediated by central and peripheral effects of angiotensin II on sympathetic activity is highly important. This is even true in angiotensin-dependent hypertension of heterozygous Ren-2 transgenic rats in which sympathetic hyperactivity is increasing with age. Central sympathoexcitation in this hypertensive model can be inhibited by lower losartan doses than peripheral angiotensin II-dependent vasoconstriction. This experimental model also yielded important knowledge on nephroprotective effects of new therapeutic drugs - endothelin receptor type A blockers. A considerable part of sympathetic vasoconstriction is dependent on the interaction of Ca2+ sensitization (RhoA/Rho kinase pathway) and Ca2+ influx (through L-VDCC). The blockade of these pathways prevents a major part of sympathetic vasoconstriction. Ca2+ sensitization seems to be attenuated in genetic hypertension in order to compensate increased Ca2+ influx. In contrast, enhanced Ca2+ sensitization is a hallmark of salt sensitivity in Dahl rats in which salt hypertension is dependent on increased Ca2+ influx. The attention should also be paid to the impairment of arterial baroreflex sensitivity which permits enhanced BP responses to pressor or depressor stimuli. Some abnormalities can be studied in blood vessels isolated from hypertensive rats but neither conduit arteries nor mesenteric resistance arteries represent the vascular beds decisive for the increased peripheral resistance and high BP. Keywords: Sympathetic vasoconstriction, NO-dependent vasodilatation, Calcium sensitization, Calcium influx, Arterial baroreflex, Spontaneously hypertensive rats, Salt hypertensive Dahl rats, Ren-2 transgenic rats, RAS blockade, SNS blockade, NOS inhibition, Endothelin, Vascular contraction and relaxation, Isolated conduit and resistance arteries, EDCF, PGI2, BKCa channels.

摘要

交感神经过度活跃和相对一氧化氮缺乏是遗传性高血压和盐敏感性高血压的典型改变。在清醒大鼠中,通过对特定血管活性系统的连续阻断,可以确定这些异常对血压维持的作用。因此,血管紧张素II的升压作用对维持高血压的贡献通常较小,但肾素-血管紧张素系统在由血管紧张素II对交感神经活动的中枢和外周作用介导的高血压发展中的作用非常重要。在杂合子Ren-2转基因大鼠的血管紧张素依赖性高血压中也是如此,其中交感神经过度活跃会随着年龄增长而加剧。在这个高血压模型中,与外周血管紧张素II依赖性血管收缩相比,较低剂量的氯沙坦就能抑制中枢交感神经兴奋。这个实验模型还产生了关于新型治疗药物——A型内皮素受体阻滞剂的肾保护作用的重要知识。相当一部分交感神经血管收缩依赖于钙敏化(RhoA/Rho激酶途径)和钙内流(通过L型电压门控钙通道)的相互作用。阻断这些途径可防止大部分交感神经血管收缩。在遗传性高血压中,钙敏化似乎减弱,以补偿增加的钙内流。相反,增强的钙敏化是Dahl大鼠盐敏感性的一个标志,其中盐敏感性高血压依赖于增加的钙内流。还应注意动脉压力反射敏感性的损害,这使得血压对升压或降压刺激的反应增强。一些异常情况可以在从高血压大鼠分离的血管中进行研究,但无论是传导动脉还是肠系膜阻力动脉都不代表对增加的外周阻力和高血压起决定性作用的血管床。关键词:交感神经血管收缩、一氧化氮依赖性血管舒张、钙敏化、钙内流、动脉压力反射、自发性高血压大鼠、盐敏感性高血压Dahl大鼠、Ren-2转基因大鼠、肾素-血管紧张素系统阻断、交感神经系统阻断、一氧化氮合酶抑制、内皮素、血管收缩和舒张、分离的传导动脉和阻力动脉、内皮依赖性超极化因子、前列环素、大电导钙激活钾通道

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